Impact of Trauma System Implementation on Mortality Rate in Alahsa, Saudi Arabia: A Retrospective Comparative Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Trauma remains a major cause of morbidity and mortality worldwide, and road traffic injuries represent a substantial public health burden in Saudi Arabia. Structured trauma systems may improve outcomes, but their regional impact in Saudi Arabia requires further evaluation. This study assessed in-hospital mortality and injury patterns before and after trauma system implementation in Alahsa, Saudi Arabia. Materials and Methods: This retrospective comparative cohort study was conducted at King Fahad Hospital, the Level I trauma center of the Alahsa Health Cluster. Trauma patients admitted during the pre-implementation period (2017-2018) and post-implementation period (2022-2023) were included if they had an Injury Severity Score (ISS) ≥15 and hospital stay >24 hours. Demographic data, injury mechanisms, anatomical injury sites, length of stay, and in-hospital mortality were analyzed. Bivariate analyses, multivariable logistic regression, Poisson regression sensitivity analysis, and interrupted time-series analysis were performed. Results: A total of 631 patients were included. Crude in-hospital mortality decreased from 19.0% before implementation to 16.3% after implementation, but this difference was not statistically significant (P=0.390). After adjustment for age, mechanism of injury, and ISS, the post-implementation period was not independently associated with mortality (AOR=0.97; 95% CI: 0.45-2.10; P=0.945). ISS and age were the strongest independent predictors of mortality. Significant shifts were observed in injury mechanisms and anatomical injury patterns, including reduced face and neck injuries and increased thoracic injuries. Conclusion: Trauma system implementation in Alahsa was associated with numerically lower crude mortality and changes in injury patterns, but mortality reduction was not statistically significant after case-mix adjustment. These findings support continued trauma registry development, pediatric trauma pathways, and subspecialty service expansion.
Source: Galen Medical Journal
Institutions: King Saud University, Ministry of Health, Ministry of Defense
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204520763